Acute scrotum: Hansen's disease versus filariasis

Abstract

Hansen's disease is caused by Mycobacterium leprae. The disease is known to involve the visceral organs including the testis apart from the skin and nerves in the lepromatous pole of leprosy due to widespread hematogenous dissemination of lepra bacilli. Furthermore, there can be testicular pain during the type 2 reaction in Hansen's disease. Filariasis is a disease caused by the parasitic nematode, Wuchereria bancrofti. This infection most commonly results in lymphedema and secondary vaginal hydrocele with an associated epididymo-orchitis. Acute epididymo-orchitis is either seen in the acute phase or as a part of secondary bacterial infections. The particular interest of this paper is to report the case of Hansen's disease who presented with testicular pain and posed a diagnostic dilemma when his pain did not respond to the standard mode of treatment and an alternate rare diagnosis was sought. This case report also emphasizes the need of reconsideration of diagnosis when the patient is not responding to standard therapy.

An unusual case of genital filariasis of the testicular tunics in an Italian patient

“…Wuchereria bancrofti is the only lymphatic filarial parasite that specifically induces genital diseases. [6][7][8][9] In Italy, some reports [10][11] have described the involvement of the genital area in cases of Dirofilariasis (i.e. Dirofilaria repens), which in rare cases presents with nodules in the subcutaneous tissues.…”